Understanding Rhesus Status and Anti-D in Pregnancy

Summary

This video explains rhesus incompatibility during pregnancy, focusing on the difference between rhesus positive and negative blood types. When a rhesus-negative mother carries a rhesus-positive baby, her immune system may create antibodies that can attack the baby’s blood cells, leading to hemolytic disease of the newborn. The video discusses how anti-D immunoglobulin injections prevent sensitization, ensuring future pregnancies are safe. The procedure includes checking the mother’s rhesus status, providing injections at critical times like miscarriage, trauma, and during the 28th week of gestation, and confirming the baby's blood type after birth.

Takeaways

• 😀 Rhesus incompatibility occurs when a mother is Rh-negative and the baby is Rh-positive, leading to potential immune system issues during pregnancy.
• 😀 Blood types consist of the Rh factor (positive or negative), which is important in determining if Rhesus incompatibility can occur.
• 😀 If a mother is Rh-negative, her immune system may react to Rh-positive blood from the baby by creating antibodies against it.
• 😀 The immune response from Rh-negative mothers may result in the destruction of the baby’s red blood cells, causing complications like jaundice.
• 😀 The condition known as Hemolytic Disease of the Newborn (HDN) can occur when the mother’s antibodies cross the placenta and attack the baby’s red blood cells.
• 😀 Bilirubin, released from the destruction of red blood cells, can cause jaundice in the baby, and severe levels can result in brain damage or long-term disabilities.
• 😀 Anti-D immunoglobulin injections are given to prevent Rh-negative mothers from becoming sensitized to Rh-positive blood.
• 😀 Sensitization can occur after a miscarriage, abdominal trauma, or during childbirth, when the mother’s and baby’s blood mix.
• 😀 Routine care for Rh-negative mothers includes receiving an anti-D injection at 28 weeks of gestation and after any sensitizing event.
• 😀 At birth, the baby’s blood type is checked, and if Rh-positive, the mother will receive another anti-D injection to prevent further complications in future pregnancies.

Q & A

What is rhesus incompatibility, and why is it important in pregnancy?

Rhesus incompatibility occurs when a rhesus negative mother carries a rhesus positive baby. This can cause the mother's immune system to attack the baby’s red blood cells, leading to hemolytic disease of the newborn (HDN), which can cause serious complications like jaundice and brain damage.

What is the rhesus factor, and how does it affect blood types?

The rhesus factor is a protein found on red blood cells. If someone has this protein, they are rhesus positive (e.g., A+, B+), while those who lack it are rhesus negative (e.g., O-). The presence or absence of the rhesus antigen is important during pregnancy, especially if the mother is rhesus negative and the baby is rhesus positive.

How does a rhesus negative mother react to a rhesus positive baby's blood?

If a rhesus negative mother’s blood comes into contact with rhesus positive blood, her immune system may treat the rhesus antigen as a foreign substance and create antibodies against it. These antibodies can cross the placenta in future pregnancies, attacking the baby’s red blood cells.

What are anti-D antibodies, and how do they help prevent rhesus incompatibility?

Anti-D antibodies are used in the form of an injection called anti-D immunoglobulin. This injection helps prevent a mother from becoming sensitized by destroying any rhesus positive red blood cells from the baby that enter her bloodstream, thus preventing the formation of harmful antibodies that could affect future pregnancies.

What are some events that could lead to sensitization in a rhesus negative mother?

Sensitizing events include miscarriages after 12 weeks, abdominal trauma, any bleeding during pregnancy, or at the time of childbirth when the baby’s blood may mix with the mother’s.

How is the risk of rhesus incompatibility minimized during pregnancy?

The risk is minimized by administering anti-D immunoglobulin injections to the mother at certain times during pregnancy (e.g., after sensitizing events, at 28 weeks gestation) and at birth if the baby is rhesus positive.

What is the significance of bilirubin in newborns with rhesus incompatibility?

Bilirubin is a chemical released when red blood cells are destroyed. In rhesus incompatibility, the baby’s red blood cells are attacked by the mother’s antibodies, leading to elevated bilirubin levels, which can cause jaundice. In severe cases, high bilirubin levels can result in brain damage or long-term disabilities.

How do medical professionals determine whether a rhesus negative mother needs an anti-D injection?

Medical professionals check the mother's rhesus status at the start of pregnancy. If she is rhesus negative, they assume the baby may be rhesus positive and provide anti-D injections after sensitizing events, at 28 weeks, and after birth if the baby is rhesus positive.

Why is it not a concern if a mother is rhesus positive?

If a mother is rhesus positive, there’s no concern about rhesus incompatibility because her body already recognizes the rhesus antigen as part of her red blood cells, and she won’t produce antibodies against it.

What are some common scenarios where anti-D immunoglobulin is administered during pregnancy?

Anti-D immunoglobulin is given during late miscarriages after 12 weeks, any abdominal trauma, bleeding during pregnancy, at 28 weeks of gestation, and at birth if the baby is rhesus positive.